When the shock is too much to bear

Traumatic events can wreak havoc on your physical and emotional health and must be dealt with by aprofessional counsellor to ensure that they don't incapacitate you in any manner.

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Rituparna Mukherjee

February 16, 2010

UPDATED: February 16, 2010 11:01 IST

The incidence of traumatic events is sharply on the rise and people need to pay attention to symptoms that indicate that these may be having a deep impact on them

You just need to take one look at the grisly headlines of a daily newspaper to get an idea of the trauma that is an intrinsic part of our lives.

Road accidents, terrorist attacks, earthquakes and tsunamis are some of the larger causes of trauma. Other harrowing events that can leave an indelible mark on our psyche include robbery and physical abuse, the death of a loved one, broken relationships, and even losing a job.

"Traumatic events can have severe repercussions on a person's mental health and even after a physical wound is cured, the psychological trauma incurred can take years to heal," says Dr Rachna Singh, consultant psychologist, Artemis Health Institute. Doctors believe stress and trauma levels are sharply on the rise, proportionate to the instances of traumatic events like robberies, terror attacks, road accidents and natural disasters. Studies have also shown that the recent recession, which saw many people losing their jobs, has also had a traumatic impact on people. An increasingly competitive environment poses all sorts of strain on people: Small arguments flare into huge fights, more people are committing suicide because of perceived slights or failures and the shelf life of relationships has shortened because of people's low levels of tolerance.

Dealing with the aftermath of these stressful scenarios is essential to stay healthy.

"The trauma that these high stress situations inflict on a person's psyche can be avoided. People should be educated on how to deal with adversity and the family support system should be strengthened," says Dr( Brig.) S Sudarshan, senior consultant psychiatrist, Dr BL Kapoor Memorial Hospital.

Different kinds of trauma

There are two types of trauma - physical and mental. Physical trauma includes the body's response to serious injury, while mental trauma is the emotional response. "Mental trauma includes frightening thoughts and painful feelings, which may arise due to serious injury," says Dr S Sudarshan. This kind of trauma may result in extreme behaviour such as intense fear or helplessness, withdrawal or detachment, lack of concentration, irritability, sleep disturbance, aggression, hyper vigilance (intensely watching for more distressing events), or flashbacks (sense that an event is reoccurring).

Fear of all kinds is yet another response. While direct exposure to traumatic events is the most harmful, second- hand exposure to violence can also be traumatic. This includes witnessing violence such as seeing or hearing about death, destruction after an earthquake, a bombed building or a plane or train crash. While physical trauma is tangible and easier to treat, the mental trauma it may lead to often goes undetected and may become deep rooted. Trauma victims often bottle up or more precisely, dissociate emotions that are beyond the comprehension of human experience and thus nearly impossible to bear or even to vent. Some recover on their own, while others grow more symptomatic if pressured to relive their tragedies by un-bottling their emotions. And proper treatment is, in most cases, more complicated than a good cry.

Children react harder

Doctors warn against being complacent about traumatic events even if they are secondhand, especially where children are concerned. The impact of traumatic events on children is greater than on adults because a child's immature mind cannot process disturbing events as easily.

"A vicious cycle ensues since the child usually cannot express what he is feeling and therefore the symptoms get suppressed," says Dr Singh. What parents don't understand is that viewing even graphic violent content on TV, reading newspaper headlines and looking at pictures can have an impact on a young mind. The child will internalise the information gleaned from such accounts, and this can have grave repercussions.

Non performance in class, rebellious behaviour, frequent tantrums and a refusal to go to places that remind them of the event are symptoms that should not be misconstrued as difficult behaviour on the part of the child. Bedwetting, playacting the event and clinging to the parents are other signs that a child is suffering from trauma or PSTD. Older children may become disrespectful and destructive. Parents should keep in mind that children can be affected very easily and thus, any event or situation that has a potential to weigh on a child's mind should be discussed openly. It is important that a child understands that the adults around him will help and support him at any cost.

"Adults may change their behaviour drastically; an outgoing person may become withdrawn and reserved, and they may be prone to frequent outbursts of emotion and depression," says Dr Sudharshan.

Personality type has a lot to do with how a person reacts to and recovers from trauma. Different people have different coping mechanisms.

How a person has been brought up and the environment he has been exposed to also influences his ability to deal with stress.Dealing with it

Addressing the issue of trauma right at the onset is the best way of dealing with it. A common mistake made by many is to avoid talking about the event responsible for the trauma in the first place. This can embed itself deeply in the psyche, making it difficult to treat later. If the event is a grievous one then the victim might suffer from PTSD, calling for medication and psychotherapy.

Psychotherapy includes cognitive or talk therapy which helps to identify and change self-destructive thought patterns. People should not balk at going to a professional mental health therapist as treatment can help bring their lives back on track. Exposure therapy is a behavioural therapy technique that helps the victim safely confront the very thing that he finds upsetting or disturbing, so that he can learn to cope effectively with it. Expression of grief and sadness or even anger at the event should be allowed. " Men especially think that crying or talking about their problems is a womanly thing to do. This notion is entrenched in them from the time they are kids rather than understanding that crying is often cathartic," says Dr Singh.

Family and peer group support is also necessary to ensure the person does not suffer from panic attacks, depression or resort to substance abuse. It is important to offer a patient ear to anyone who has been through a traumatic scenario. Neuro- linguistic programming ( NLP) and hypnotherapy have also proved to be successful treatments for those suffering from mental trauma but it is necessary to go to a properly qualified specialist for this form of therapy to work.

Support is vital

Don't expect anyone who has been through a traumatic incident to be tough or ' snap out of it' quickly. Friends and families of the victim should make an extra effort to spend more time with him, even if he is withdrawn and remote. Those caring for someone with extreme trauma or PTSD may also be affected by the pain and grief of the victim: Hearing about the trauma that led to a loved one's PTSD may be extremely painful. In fact, the term " compassion fatigue" was coined to describe the feelings, such as depression and helplessness that commonly develop in those close to a person with PTSD. "The experience may cause you to relive difficult events in your own life. The person you love may seem like a different person than you knew before the trauma - angry and irritable, for example, or withdrawn and depressed," says Dr Singh. Commonly, those caring for victims of trauma may find themselves avoiding any attempts to talk about the trauma, or feeling hopeless that the symptoms will improve. At the same time, they may feel guilty about not being able to help a traumatised loved on or hurry up his process of healing. This will have a negative effect on the process of healing "It's critical that you make your own mental health a priority. Eat right, exercise, and rest. Continue to take time alone or with friends, doing activities that help you recharge," says Dr Singh.

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